Archives for: October 2009
10/30/09
Medicaid Providers to Certify a Valid Compliance Plan is in Effect by December 1, 2009
In July of 2009 the NYS Office of Medicaid Inspector General (OMIG) released its regulations regarding Compliance Programs applicable to all Medicaid providers who submit claims for $500,000/year or more in addition to all providers licensed under Public… more »
Federal Fraud Enforcement and Recovery Act of 2009
The Federal Fraud Enforcement and Recovery Act of 2009 (FERA)enacted in May 2009 is an expansion of the Federal False Claims Act with significant implications to Medicare/Medicaid providers. FERA redefines a "claim" to include not only claims submitted… more »
10/29/09
House Democrats Reach Deal on Key Elements in Health Care Bill
A deal has been reached today by House Democrats on the key aspects of the health care bill that would essentially transform the medical landscape in the United States. The new legislative framework will require practically universal sign-ups and establ… more »
HHS Considers Medicare and Medicaid Fraud Summit
Health and Human Services deputy secretary William Corr announced today that the Obama administration is considering a Medicare and Medicaid Fraud Summit bringing together patients, doctors, insurers and law officers as a step toward more effective way o… more »
Physician Liability for Certifications in the Provision of Medical Supplies and Home Health Services
The Office of Inspector General issued a Fraud Allert reminding physicians to be cognizant of the legal significance of certifications they make in connection with the ordering of equipment as well as home health services for their Medicare patients. Th… more »
10/28/09
OBS Adverse Event Reporting Reminder
The New York State Department of Health advises that it has received numerous incomplete Adverse Event Report forms. The items most often left blank include the date of the adverse event, procedure codes, level of anesthesia and drug information, and blo… more »
10/27/09
Awareness of Issues Addressed in OIG Reports Necessary in Today's Regulatory Environment
Reviewing the audits conducted by the Office of Inspector General can help physicians identify some challenging ares withing their operations. This week CMS published a transmittal focusing on recent OIG reports pertaining to among others Part B Billing… more »
Office of Inspector General Work Plan for Fiscal Year 2010
The Office of the Inspector General released a Work Plan for Fiscal Year 2010 enumerating issues on target for review for both Part A and Part B Medicare. Healthcare providers and compliance specialists are encouraged to examine the OIG Work Plan as par… more »
Medicare Guidance on Reporting Surgical Errors
In June 2009, Medicare released three National Coverage Determinations (NCDs) for several gross surgical errors including wrong surgical or other invasive procedure performed on a patient, surgical procedure performed on the wrong body part and surgical… more »
06:17:51 pm, by Kristina Giyaur 
, 27 words 
Categories: News and Announcements, Medicare and Medicaid
CMS Updates Overpayment/Underpayment Interest Rate
Effective October 22, 2009 CMS implemented new interest rates for Medicare overpayments and underpayments. According to a quarterly update, CMS contractors were directed to utilize an interest rate of 10.875 percent. more »
06:16:18 pm, by Kristina Giyaur , 67 words
Categories: News and Announcements, Medicare and Medicaid
Pharmacies Urged to Enroll in Medicare Part B
Medicare Part B covers certain drugs, medical supplies, and other products under certain circumstances. When a drug, medical supply, or enteral formula meets the conditions for payment under Medicare Part B, the claim should be submitted for Medicaid re… more »
New York Attorney General Supports New Website to Allow Patients to Compare Prices Before They Choose Doctors
New York Attorney General Andrew Cuomo said today that health insurers are putting up $100 million to pay for a new database, which will allow consumers for the first time to compare prices before they choose their doctors. The new entity will create… more »
Significance of the Fraud Enforcement and Recovery Act of 2009
"Clarifications to the False Claims Act to Reflect the Original Intent of the Law," of the federal Fraud Enforcement and Recovery Act of 2009 (FERA, Section 4) signed by President Obama on May 20th, has major significance for health care providers and al… more »
US Office of Medicaid Inspector General Announces Results for FY 2008 and Publishes Health Care Fraud and Abuse Control Program Report
During 2008, the Federal Government won or negotiated approximately $1 billion in judgments and settlements, and it attained additional administrative impositions in health care fraud cases and proceedings. The Medicare Trust Fund received transfers of a… more »
Senate Healthcare Bill to Include Public Option
Senate Majority Leader Harry Reid said today that his chamber's healthcare bill would include a compromise that would create a nationwide public option but give states the right to opt out. more »
NY Suspends Mandatory H1N1 Immunization Requirement
On October 22, 2009, Governor Patterson announced the suspension of the mandatory H1N1 vaccination requirements for NY healthcare workers due to limited availability of the vaccine. more »
XML Feeds
